chapter  Three
Medicine, Moralism, and Social Control
WithHoward F. Stein, Margaret A. Stein
Pages 30

This chapter describes the meaning of informal clinical taxonomies such as “good” and “bad” patients; the physician who cures as a “success” and the physician who cannot cure as a “failure”. Moralism is not only a consequence of values and metaphors intrinsic to the culture of medicine. It is likewise induced from the wider society in terms of the social control role medicine is expected to play; that is, it is part of the object relation based division of labor between physicians and their public. At family medicine grand rounds, a resident presented the sad case of a fifty-year-old white married male. He had a history of well-controlled hypertension and well-controlled diabetes. Physicians and other biomedical practitioners, in addition to functioning according to an official, scientific diagnostic schema, operate according to an unofficial, moralistic taxonomy of types of patients.